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August 5, 2003

Family Planning

Question from New Orleans, Louisiana, USA:

I am a 20 year old girl who has had type 1 diabetes for almost 18 years, and for the most part, it has been in good control. I plan to have children in the next five years, but I recently found out that I am not ovulating every month. I'm concerned because I have read several articles about infertility problems and diabetes. Does this mean I won't be able to have children?

Answer:

No, it doesn’t necessarily mean you can’t have children, but you may have more difficulty than average conceiving. Don’t assume you aren’t fertile and make sure you use birth control if you are sexually active before you wish to conceive.

If you do ovulate some months, but not others, you may have trouble predicting when your “fertile time of the month” is, but that doesn’t mean you won’t conceive naturally. If after 6-12 months of trying to conceive, you are unable, you should consult a fertility specialist.

First of all, I’d make sure your thyroid function is normal since abnormal thyroid function is common in people with diabetes, can cause menstrual irregularities, and is easily treated with thyroid medication. Achieving the best blood sugar control possible at least six months before you plan to try becoming pregnant will both help make your cycles more regular and decrease the chance of birth defects which occur more frequently in women who don’t have good control both before they conceive and during the first trimester when organs are forming in a developing fetus.

TGL

[Editor’s comment: See Planning a pregnancy , at the Diabetes Monitor, for some additional thoughts.

WWQ]